PruittHealth Member Advocate (Insurance Sales/Marketing) in North Carolina

Member Advocate (Insurance Sales/Marketing)

Description

Role Summary/Purpose- Position is with AllyAlign (A PruittHealth Partner)

Institutional Special Needs Plans (I-SNPs), which are a formof Medicare Advantage Plans. We will be covering the medicalcosts of people who are eligible for Medicare and who reside in our nursing facilities.Wehaveestablished the Member Advocate role to serve as a point of contact for themember and/or their families during their coverage period with theI-SNP.

Competitive Salary – commensurate with experience plusquarterly bonus if required goals are met;

Competitive Benefits Package – health/dental/visioninsurance, 401K

Travel – required within region (frequent), statewide(infrequent), and corporate headquarters in Richmond, Va (infrequent)

Responsibilities

This position is considered a work-from-home position as noformal office space/work location is provided. The Member Advocate conducts themajority of their work within Partner nursing homes in the MemberAdvocate-specific work region.

The following defines the responsibilities of the MemberAdvocate in serving our members.

Develop and implement a comprehensive facility-specificmarketing plan for each targeted Partner nursing home. As necessary, a MemberAdvocate will be expected to modify and enhance facility marketing plans basedon achievement of enrollment goals

Organize in-service events to gain maximum exposure toresidents and their responsible party/family. Prepare and deliver a formalpresentation, approvedby CMS, forthose attending the in-service.

Once enrolled, follow up with the member to ensure that any questionsare answered, act as a point of contact if the member or their family needsassistance with the plan, or providethem with periodic updates about theplan;

Act as front line support as needed with the member, partnerfacility and integrated care team to ensure the needs of the Member and Planaremet.

Develop and maintain relationships with key networkproviders/facilitieswithin assignedregion; support continued regional network development activities necessary tomeet network adequacyrequirements;

Meet with the member and/or their family at leastmonthly;

Conduct quarterly customer service surveys with the memberand/or theirfamily; based on theresults of the survey, follow up on any items that the members are dissatisfiedwith;

Develop and maintain reporting to include but not limited tomanagingmember status,daily/weekly/monthly facility calendar, issuestracking/management

Ensure that ALL interactions with the member are compliantwith CMSregulations

The Member Advocate will be responsible for a group ofnursing facilities; the Member Advocate is responsible for ensuring that theabove services are carriedout foreach of the members in your assigned group offacilities

Qualifications

Qualifications/Requirements

The following requirements must be met for a candidate to behired into this position:

Currently hold a license to sell health insurance and be in goodstanding with the licensing board preferred but not required; or, ability topass the educational requirements and testing required to obtain the license inyour state of residence. Reimbursement for licensing fee and up to $250 forexam preparation materials andfees;

Compliant, at all times, with CMS regulations regardingMedicare AdvantagePlans

Exceptional interpersonal skills with demonstrated ability towork independentlyas well as witha team; must be a good listener to understand feedback raised by the potentialmember/family;

Three or more years of experience successfully working in ahealthcare delivery setting with elderly patients as either a clinician, socialworker or caregiver.Nursing homeexperience ispreferred but notrequired;

Exceptional organizationalskills;

Strong written and verbal communication and clear thinkingskills with the abilitytosynthesize complex issues into simplemessages;

Ability to work well with staff at each of the nursing homesin the assigned region to include program director, nursing staff, doctors andadministrationstaff;

Ability to deliver outstanding customerservice;

Willingness and ability to travel to facilities within yourassigned region; have dependable transportation, a current driver’s license, aclean driving record, and proof ofinsurance;

Strong proficiency in computer skills in Microsoft OfficeSuiteproducts;

Have suitable home workspace allowing for productive officeenvironment.

Job Administrative

Primary Location North Carolina

Other Locations North Carolina-Rockingham, North Carolina-Durham, North Carolina-High Point, North Carolina-Monroe, South Carolina-Rock Hill, North Carolina-Harrisburg, North Carolina-Brevard, North Carolina-Raleigh, North Carolina-Charlotte, North Carolina-Farmville

Schedule Full-time

Shift 1st Shift

Job Posting Jan 15, 2019, 8:33:09 AM

Req ID: 1900440

PruittHealth is an Equal Employment Opportunity employer and does not discriminate in its personnel practices against its partners or qualified applicants for employment based on race, color, religion, sex, national origin or because he or she is an individual with a disability or a protected veteran.